[Kok! Health] "Child who went swimming keeps scratching ears"... Beware of otitis externa

Children who have been playing in the water during the summer often frequently touch or scratch their ears. If they are old enough to speak, they might express that their ears are itchy, but for young children who cannot communicate properly, it is difficult to know exactly why they are scratching their ears. Even when there is no significant problem inside the ear, slight itching can occur due to earwax or foreign substances. However, after enjoying water activities, inflammation symptoms such as otitis media or otitis externa should also be considered.

Children visiting Gwanghwamun Square in Jongno-gu, Seoul, are cooling off by playing in the water. Photo by Jin-Hyung Kang aymsdream@

The ear canal is lined with skin extending up to the eardrum. Itching is the most common symptom of skin diseases and occurs due to physical or chemical irritation of the skin. The most common cause of severe ear itching that requires a hospital visit is acute otitis externa. Otitis externa is an inflammation of the external auditory canal, the passage from the auricle to the eardrum, caused by bacterial or fungal infections. The main symptoms are ear pain and itching.

It is especially common after swimming, which is why otitis externa is sometimes called "swimmer's ear." Professor Ahn Yong-hwi of the Department of Otorhinolaryngology at Nowon Eulji University Hospital explained, "In children, when acute otitis media occurs, the eardrum may rupture, causing pus inside the eardrum to leak into the ear canal, which can cause itching." He added, "It is difficult to distinguish between otitis externa alone and otitis media accompanied by otitis externa based on symptoms alone, so it is necessary to receive an accurate diagnosis and appropriate treatment from an otolaryngology specialist."

Otitis externa is diagnosed through a simple medical history and otoscopic examination. If it is a simple otitis externa, the first step is to control pain with medication and keep the ear canal clean. For this, ear drops containing antibiotics or steroid-containing solutions to reduce inflammation are used. The second step involves carefully removing secretions and necrotic skin from the ear canal and cleansing it with an acidic solution to restore the ear canal's acidity. A normal ear canal has an acidic protective layer with a pH of about 6.0 that inhibits bacterial growth. At the same time, the ear canal skin undergoes continuous shedding and natural cleaning through the movement of earwax. However, exposure to swimming pool water or using cotton swabs can alter the ear canal's acidity, disrupting its defense against inflammation, so restoring the acidity is necessary. Most cases improve within 3 to 7 days, but if inflammation is suspected to have spread beyond the ear canal, radiological examinations are needed to rule out skull base osteomyelitis.

Professor Anyonghui, Department of Otorhinolaryngology, Nowon Eulji University Hospital.

The most important way to prevent otitis externa during water play or in daily life is not to clean the ear canal with cotton swabs. Scratching inside the ear with cotton swabs because water has entered or the ear feels itchy weakens the ear canal skin and creates an environment prone to otitis externa. It is best to leave small amounts of water to evaporate naturally and dry on their own. If there is a lot of water causing discomfort, tilting the affected ear downward and shaking or hopping can help remove the water. Using a hairdryer or fan with warm, gentle airflow to dry the inside of the ear is also recommended.

Professor Ahn explained, "The 'vinegar-water therapy' using vinegar and saline to acidify the ear canal can also be helpful. Mix vinegar and saline in a 1:2 ratio, put 3 to 4 drops into the ear canal at a time, leave it for about 5 to 10 minutes, then wipe it out. Repeat this 2 to 3 times a day." He continued, "Symptoms that start with mild itching can cause children to scratch their ear canals, leading to skin injuries. This worsens inflammation and skin damage, causing discharge, which in turn triggers more itching, creating a vicious cycle that can progress to chronic otitis externa." He emphasized the importance of not touching the inside of the ear even if it itches and the importance of early treatment.

This content was produced with the assistance of AI translation services.